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Exercise For Parkinson’s Disease

A picture of Dickie White and his Dad, Dick.  Dickie is eating a cookie and his Dad is looking at him with a weird smile.

Hi, I’m DickFarm and I’m a lucky guy!

What makes me so lucky?

Well, for one, I have a great dad. He’s always been there for me and is one of the most selfless individuals I know.

So, when he was diagnosed with Parkinson’s Disease about 4 years ago, I immediately got to work doing whatever I could to help; he undoubtedly would have done the same for me.

I looked into research.

I read as many books as I could get my hands on (even old college text books).

I searched the great and powerful Google.

And, of course, I put together an exercise program for him to follow.

The first few months of the program was just general GPP work. He wasn’t in the shape he is now so I kept things basic and focused on weekly progressions in the volume. For an example of how I did this, read this post.

After that, I designed a new program, one that was focused on constant variation. I believed that regular changes would provide the best environment to minimize progression of the disease.

With a high degree of variation, I thought I could “keep his body/nervous system guessing,” and thereby decrease the rate at which the disease progressed.

I rotated exercises once every 2-3 weeks and the program contained 3 blocks of training. My dad, his neurologist, and I all thought he responded well to it. However, the couple of times that I went with my dad to his neurologist appointments, I was concerned about the examination process.

Now, don’t get me wrong. I’m not a doctor, or an expert in really anything. On top of that, my parents and I both have a lot of trust and confidence in my dad’s neurologist. But, the one thing that concerned me was the brevity of the exam he gave to my dad every 6 months.

He had him walk up and down a hallway, touch his index finger and thumb together as quickly as possible, touch his index finger to his nose, stand with his eyes closed, and a few other tests.

These are all good tests. And again, I trust this guy a lot. However, I was concerned that a subjective-ish measure of a handful of gross and fine motor tests provided a fair assessment of how my dad was truly functioning.

So I asked myself, what could I do to improve his program and focus more on function while making things as measureable as possible?

The First Steps

First, I worked with my dad to identify some of the most important movements in his life. Here’s what we came up with:

1. Walking. Getting around smoothly and confidently without fear of tripping and/or falling was very important. It seems like this isn’t that major to the average person, but to someone with Parkinson’s, maintaining this function means a lot.

2. Getting up and down off the ground.

3. Getting up from a seated position, especially when the seat put his thighs in a close to parallel position to the ground.

4. Right arm and right leg function. His right arm and right leg are most affected by PD. So I wanted to continue to include single arm and single leg exercises to ensure he got direct work and wasn’t able to compensate with the left side of his body.

In addition, I wanted to continue to address some other key areas including:

1. Core stability and endurance. He’s had some issues with a tight back before and it’s resulted in a decreased performance during his training sessions.

2. Power. I’ve read that power is the quality most likely to suffer in aging adults.

On top of all this, at the time I was reading a lot of Bonderchuk. One of the core principles that really jumped out at me was an emphasis on fewer exercises. He suggests that there will be a greater chance for adaptation since the body will be less confused.

So, with that information, I decided to whittle some things away and implement a program with a lot less week to week variation.

A Trip To Rock Steady

Around the time of this program re-design, my Mommy and I took a wonderful trip to Indianapolis to visit the Rock Steady Boxing Club.

It was an awesome experience. We both learned a lot, and it also gave me confidence with what my dad was doing.

While there were a lot great memories, there was one thing in particular that stood out.

During one of the training sessions we shadowed, I saw one of the participants hit a speed bag better than I ever have.

Listen, I’m far from an expert with my hands. But, I have boxed for a number of years as part of my MMA training. And this man made me look like a child.

The most impressive part?

He was first diagnosed with Parkinson’s over 16 years ago and in day to day life, he has noticeable tremors. As soon as he started hitting the speed bag, the tremors disappeared.

My mom and I were both blown away with his proficiency and rhythm.

When she asked him how he was able to hit the bag so well he responded that he had done it for so long that it was just second nature at this point.

That’s when a light went off in my head. …I know, it’s hard to believe.

The Bonderchuk, the specificity, everything just came together for me.

And this is what I came up with…

The Program

The Walk

After a brief warm-up, each day begins with walking on the treadmill. I thought, what better way to improve someone’s ability to walk then by walking?!

Ok, this is semi-sarcastic.

But in all honesty, haven’t we all fallen victim to this before? For years as a powerlifter I used lots of squat, bench, and deadlift variations, but I didn’t train a whole lot of straight weight competition lifts. In hindsight, I feel as though this really limited my potential.

Anyway, a few months ago when he started the program I had him select the speed that he felt comfortable walking at. He chose 1.4 mph and was only able to go for about 7 minutes before he felt like his balance was becoming compromised.

In case you don’t know what a 1.4 mph walk looks like, I hope this gives you an idea. One day the famous Tree Man saw him walking at that speed and said, “If you were going any slower you’d be going backwards.”

Regardless of how slow it was, at least we had a measurable starting point.

As the weeks went on, I simply looked to progress him .1 mph or increase the time.

Was it a perfect, predictable linear progression?

No.

But, at the time of writing this, he’s able to walk at 3.1 and 3.2 mph for 12 minutes.

In addition to more than doubling his walking speed, I’ve seen great carryover to his daily life. The shuffling style he previously walked with appears to have gone away. As a result, his risk of tripping and falling is a lot lower.

And, from a selfish standpoint, when we walk together, I don’t need to slow down like I once had to.

I know this may sound like minor stuff, especially if you’re one of the many high level lifters at Ironworks. But, when you have PD, making such drastic improvements in your ability to get around means extending, and even perhaps eliminating, your chances of having to get a walker or be confined to a wheelchair. Both of these, I’d imagine, are pretty major life events for someone.

Day 1

Once he’s done walking, it’s time to pump some iron!

Right now each day starts with a 4 exercise circuit. The gym is usually quiet in the morning so he can get away with this. In busier conditions, you could simply perform 2 separate supersets.

On the first day, this is what it looks like:

Vertical Jump to Mats (4×5). This is to measure and train lower body power. I stack the 3/4-inch mats and add/subtract based on how he’s doing that day.

Ab Wheel (4×10). This is to address the core stability goal I mentioned above.

Single Arm Cable Row with a hold (4x12ea). This is to attack the arm imbalance. I like to add the hold for increased activation.

Single Arm Bench Press (4×8-12ea). This is another exercise for the upper body imbalance I mentioned above.

After the 4 exercise circuit, I have him perform a tri-set. On day 1 he does the following:

Box Squat (4×10). I had him start on a high box and slowly worked him down over the course of many weeks. He can now perform all his sets on the Rogue box set at 11-inches without having to do a warm-up set on a higher surface first.

Kettlebell Loading (4×8-12). I included this because I thought having a means to measure and track his ability to pick things up and put them on an elevated surface would be helpful. He’s progressed in weight from a 25-pound Kettlebell to a 70-pound Kettlebell. He’s been able to maintain 12 reps in less than 30 seconds. Each rep finishes with the bell on top of 4 stacked Jerk boxes.

Jacob’s Ladder (4×30-45 seconds). This is a new addition as of a few months ago. It’s super hard, has a single leg element to it, and requires some coordination. So I thought it’d be worth including. Based on his feedback and my observations, we’ll adjust this as needed.

Day 2

The first 4 exercise circuit is as follows:

Prowler Sprint (4x). This is another single leg exercise to improve power production.

Pallof Press (4x10ea). For core stability/endurance.

Blast Strap Row (4×12-15). A general upper body pulling exercise.

Blast Strap Pushup (4×10). An upper body pushing exercise with an added stability challenge.

The tri-set looks like this:

Get Ups (4×6-8). I stole this from Dan John and boy does my dad love them (more sarcasm)! I have him perform these on the mats. He starts on his back and simply sits up, gets his legs under him, and stands up. When I first timed him, he was able to perform 6 reps in about a minute and ten seconds. This past week he did a set of 6 in 45 seconds. He has made comments to me that these have been a big help specifically during some training scenarios that he’s gone through with the Port Crane Fire Department.

Single Arm Overhead Press (4x10ea). Another single arm movement to address the imbalance. He and I have found that pressing a Kettlebell with his right arm helps to keep his arm as vertical as possible.

Elliptical Sprint (4×30 seconds). Just like the Jacob’s Ladder, this is another new addition. It will help increase his work capacity and help to increase the firing rate of his neurons.

Day 3

The first 4 exercise circuit is as follows:

Standing Horizontal Jump (4×5). This is another lower body power exercise. I have him try to jump over one of the square 3/4-inch mats. Currently he’s able to clear the mat about half the time.

Back Extension (4×12-15). To address the core stability/endurance focus.

Single Arm Pulldown (4x10ea). To address the arm strength/function imbalance.

Bar Pushup (4×10). A general upper body strength exercise and measure of relative strength.

The tri-set looks like this:

Split Squat and Step Up (4×8 each leg, 2 sets each exercise). Both are trained for improving function (climbing stairs, getting up off the ground in a staggered stance). Simultaneously, these exercises address the imbalance between his right and left leg.

DB Snatch (4x6ea). This is more of a general, full body power exercise.

Battling Ropes (4×30). I like to use the ropes to attack the upper body imbalance. In addition to weakness in his right arm, he also has a limited range of motion. I think that using the ropes with a big range of motion helps to address this.

The Results

I mentioned some of the improvements above, but here’s a summary. All original numbers are from June of last year when he first started on this program.

Walk then- 1.4 mph for 7 minutes.
Walk now- 3.1-3.2 mph for 12 minutes.

Box Squat then- performed to a 12″ box plus 2 Airex blue balance pads stacked on top.
Box Squat now- performed to an 11″ box.

Kettlebell Loading then- 25 pounds for 12 reps in :30.
Kettlebell Loading now- 53 pounds for 12 reps in :28. 70 pounds for 12 reps in :34.

Get Ups then- 6 in 1:10.
Get Ups now- 6 in :45 is his best, he averages 6 in :50-:55.

He’s improved in the other exercises as well, but these have been some of the key focuses thus far.

Finally, here’s what he had to say in the testimonials video:

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